Bone graft forming guide

ABSTRACT

A bone graft forming guide for providing a bone graft and a method of forming a bone graft. The guide includes a main body including a holder for holding a graft material and guide containing a pattern generally corresponding to the desired shaped of the bone graft. The forming guide may include a hole guide containing a plurality of hole guides arranged in a pattern generally corresponding to the desired shape of the bone graft. The forming guide may further include a cutting guide containing a pattern corresponding to the desired shape of the bone graft.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] The present application is a divisional of U.S. Application No.09/742,923 filed on Dec. 21, 2000.

FIELD OF THE INVENTION

[0002] The present invention relates to bone grafts for use in therepair, replacement, and/or augmentation of various portions of animalor human skeletal systems. More particularly, the present inventionrelates to a prepared bone graft, guides for forming bone grafts andmethods of forming bone grafts.

BACKGROUND OF THE INVENTION

[0003] Several procedures involve the use and implantation of autograftbone, allograft bone or xenograft bone into an animal or human body. Atleast some of the benefits of implanted bone includes providing support,promoting healing, filling bony cavities, separating or spacing bonyelements such as vertebral bodies, promoting fusion, and stabilizing thesite of fractures.

[0004] In one known procedure, a donor bone from a cadaver is selectedand prepared for insertion into a patient. For example, a spinal implantmay be prepared by selecting a femur or tibia bone and cutting the boneto a desired shape. Alternatively, a portion of a bone can be cut fromthe patient receiving the implant, usually from a large bone such as ahip bone. In another known procedure, the bone graft can be a syntheticmaterial which has been formed to a desired size and shape.

[0005] Typically, bone grafts are prepared outside the operating room ina production facility, and inserts are prepared having a variety ofshapes and sizes so that the physician performing a bone implantoperation can select a properly sized and shaped implant for eachpatient and procedure. Production of bone graft can be expensive becausethe production facility must be capable of producing sterile implants,and the bone graft must be stored prior to use in an operation.

[0006] For many procedures, it may be desirable to provide a roughenedor irregular surface on at least one surface of the finished bone graftto promote fusion of the graft to adjacent bone in the body. Inaddition, during an operation requiring an insert having a very precisesize and shape, for example, a discectomy and spinal fusion procedure, asurgeon must have on hand a variety of bone graft sizes and shapes toprecisely fit the bone graft into the disc space of the patient afterpreparation of the bone graft, which may include surgical removal of aruptured or degenerated disc or a portion thereof.

[0007] Presently known methods for preparing bone grafts haveshortcomings. One shortcoming is the cost of manufacturing bone graftsand sterilizing and storing the bone grafts in a production facility.Another shortcoming is the difficulty of forming a roughened orirregular surface on a bone graft, particularly after the bone graft hasbeen cut to a desired size and shape. Formation of the roughened orirregular surface typically requires machining after cutting of the bonegraft, and this may alter the dimensions or shape of the bone graft.

[0008] In view of these and other shortcomings associated with providingbone grafts, it would be desirable to provide an improved method andapparatus for the manufacture of bone grafts. Such a method should berelatively simple, inexpensive and provide the flexibility of allowingthe bone graft to be prepared intraoperatively in an operating room.

SUMMARY OF INVENTION

[0009] Accordingly, the present invention generally provides arelatively simple bone graft forming guide and a method of forming abone graft. The method includes the steps of selecting the shape of atleast a portion of a bone graft and forming a plurality of holes in agraft material. According to one aspect of the invention, the pluralityof holes forms a pattern generally corresponding to the intended shapeof the bone graft. The invention may further include cutting at leastpartially through the graft material along the pattern formed by theplurality of holes.

[0010] According to one aspect of the invention, the cutting stepincludes cutting through at least a portion of the plurality of holesresulting in a portion of the bone graft having a roughened surface.Another aspect of the invention includes providing a drill guidecontaining a plurality of hole guides arranged in a pattern generallycorresponding to the intended shape of the bone graft. According to thisaspect of the invention, the method includes positioning the drill guidewith respect to the graft material and drilling into the graft materialusing a least a portion of the hole guides.

[0011] In another aspect of the invention, the method may furtherinclude providing a cutting guide having a pattern corresponding theintended shape of the bone graft, positioning the cutting device withrespect to the graft material, and cutting the graft material using thecutting guide. In another aspect, the drilling step includes drillingthrough the graft material and the cutting step includes cutting throughthe graft material.

[0012] According to a preferred aspect of the invention, the method isperformed intraoperatively in an operating room. This aspect of theinvention provides the surgeon performing a bone graft insertionprocedure with the flexibility to select a properly sized and shapedbone graft in the operating room. According to prior art methods, asurgeon would have to purchase various differently sized and shaped bonegrafts that are fabricated in a facility outside the operating room. Forexample, according to one aspect of the invention, a spinal bone graftmay be formed in a generally elliptical shape with respect to thecutting direction. According to this aspect of the invention, the holeguide and the cutting guide have a pattern that is generally ellipticalin shape. According to another aspect of the invention, a spinal bonegraft can be produced that is generally cut in a wedge shape.

[0013] Another aspect of the invention pertains to a method of forming abone graft from a graft material including the steps of selecting theshape of at least a portion of the bone graft, providing a graftmaterial holder and selecting from a plurality of cutting guides, eachof the cutting guides having a different cutting pattern. According tothis aspect of the invention, the method further includes associatingthe cutting guide with the graft material holder and cutting at least aportion of the bone graft material using the cutting guide.

[0014] Another aspect of the invention involves a bone graft formingguide for providing a bone graft having a desired shape. According tothis aspect of the invention, the cutting guide has a main bodyincluding a holder for holding a graft material and a cuttingguide-receiving structure. This aspect of the invention also includes acutting guide containing a pattern corresponding to the desired shape ofthe bone graft, and the cutting guide adapted to be detachably mountedto the main body.

[0015] According to another aspect of the invention, the forming guideincludes a main body having a holder for holding a graft material and ahole guide containing a plurality of hole guides arranged in a patterngenerally corresponding to the desired shape of the bone graft. Theforming guide further includes a cutting guide containing a patterncorresponding to the desired shape of the bone graft.

[0016] In one aspect of the invention, the hole guide is an insert andthe main body includes a guide receiving opening to receive the insert.In another aspect, the cutting guide is an insert and the main bodyincludes an opening to receive the insert. According to this aspect ofthe invention, the forming guide includes a securing mechanism forremovably securing one or both of the hole guide insert or the cuttingguide insert in the opening.

[0017] In a preferred embodiment, the securing mechanism includes a cammember associated with the main body. Preferably, the cam membercooperates with one or both of the hole guide insert or the cuttingguide insert to secure one or both of the inserts to the main body. Inanother aspect of the invention, the hole guide insert and the cuttingguide insert include a ridge adapted to cooperate with the cam member.

[0018] According to one aspect of the invention, the main body of thebone graft forming guide includes a block adapted to receive a graftmaterial. Preferably, the block includes two members connected by ahinge. Preferably, the main body further includes a closure means suchas a clamping mechanism for clamping the two members towards each otherto secure the bone within the cutting guide. Preferably, the clampingmechanism includes a threaded rod and nut assembly.

[0019] According to another aspect of the invention, the forming guideincludes a handle and a shaft having a proximal end and a distal end.The proximal end of the shaft is attached to the handle, and a pair ofjaws extends from the distal end of the shaft. The jaws are movablebetween a gripping position to grip graft material during cutting of thebone graft and a releasing position to release the implant. According tothis aspect of the invention, the handle includes pair of arms connectedto the pair of jaws to provide a pair of gripping members that arepivotally joined. Preferably, the pair of arms includes a lockingmechanism to lock the cutting guide in a plurality of positions.According to this aspect, the cutting guides are attached to at leastone of the jaws. In a preferred aspect, the hole guide and the cuttingguide are removable inserts. Alternatively, the hole guide and thecutting guide may be integrally formed in at least one of the jaws.

[0020] Another aspect of the invention relates to a bone graft formingguide including a handle and a shaft having a proximal end and a distalend. The proximal end of the shaft is attached to the handle, and a pairof jaws extends from the distal end of the shaft. According to thisaspect of the invention, a cutting guide is associated with the jaws,and the jaws are movable between a gripping position to grip graftmaterial during cutting of the bone graft and a releasing position torelease the implant. Preferably, the handle includes a pair of armsconnected to said pair of jaws to provide a pair of gripping members,the gripping members being pivotally joined.

[0021] The present invention provides a relatively simple andinexpensive way to make bone grafts. A surgeon can select a from avariety of hole guides and cutting guides to provide various sized andshaped bone grafts for a procedure. Advantageously, the method andforming guide of the invention can be used intraoperatively in anoperating room setting. By forming a plurality of holes in the graftmaterial prior to cutting of the graft material, a roughened surface isprovided on at least one surface of the bone graft. In one preferredaspect of the invention, the hole guides contain round holes, and thecutting guide is positioned such that the cutting device cuts throughthe approximate center of the holes to provide a roughened or ridgedsurface on at least one surface of the bone graft. The roughened surfacepromotes ease of insertion of the graft and fusion of the bone graft toan adjacent bone after insertion in the body.

[0022] Additional features and advantages of the invention will be setforth in the description which follows. It is to be understood that boththe foregoing summary and the following detailed description areexemplary and are intended to provide further explanation of theinvention as claimed. In the following drawings, like referencecharacters denote similar elements throughout the several views.

BRIEF DESCRIPTION OF THE DRAWINGS

[0023]FIG. 1 is an exploded perspective view of a bone graft formingguide in an open position and a bone graft material according to oneaspect of the invention.

[0024]FIG. 2 is a perspective view of the forming guide of FIG. 1 in aclosed position showing the bone graft material and a cutting insert inassociation with the forming guide.

[0025]FIG. 3 is a top plan view of a forming guide according to oneaspect of the invention.

[0026]FIG. 4 is a front view of the forming guide of FIG. 2.

[0027]FIG. 5 is a cross-section view taken along line 5-5 of FIG. 2.

[0028]FIG. 6 is a perspective view of a bone graft in accordance withthe invention.

[0029] FIGS. 7A-7D show top views of examples of cutting inserts inaccordance with the present invention.

[0030]FIG. 8 is a perspective view of a bone graft forming guideaccording to another embodiment of the invention; and

[0031]FIG. 9A-9C shows a partial perspective view of bone graft formingguides according to other embodiments of the invention.

DETAILED DESCRIPTION

[0032] An exemplary embodiment of the present invention is shown inFIGS. 1-7 and is designated generally by reference numeral 10. Asembodied herein and referring to FIG. 1, a bone graft forming guide 10for forming a bone graft having a desired shape includes a main body 12and a cutting guide 14. In this embodiment, the main body is in the formof a block of material adapted to receive and, preferably, position agraft material. Preferably, the block of material comprises two members22 and 24 connected by a hinge.

[0033] As best shown in FIGS. 1 and 5, the hinge preferably includes apin 28, which cooperates with hinge members 30 and 32 associated withmain body members 20 and 22 to join the two members together and providean axis of rotation for opening and closing the forming guide in use. Itwill be appreciated, of course, that the invention is not limited by arequirement for separate body members or a requirement for a particularmeans of joining the members together or a specific hinge member. Forexample, the two members 20 and 22 may be joined together by a livinghinge (not shown), wherein during the manufacturing process of theforming guide, a thinned section is provided that functions as a hingeand allows the two members to open and close. Other types of hinges arealso within the scope of the invention, such as, for example, a pianohinge. Or, there may be no hinge at all, the two members being joined byany number of mechanical means.

[0034] As will be described in more detail below, the cutting guide 14has a cutting pattern corresponding to the desired shape of the bonegraft. The main body 12 of the forming guide 10 includes a holder 16 forholding bone graft material 18 during formation of the bone graft. Theholder 16 may include a plurality of splines 34 on the inner surface ofthe main body for holding the bone graft material 18 during the formingoperation. Preferably, the splines 34 are adapted to at least partiallydeform when they contact the graft material 18 and hold it in placeduring cutting of the bone graft material into a desired shape.

[0035] According to a preferred aspect of the invention, the cuttingguide 14 is adapted to be detachably mounted to the main body 12 of theforming guide. One example of various ways in which the cutting guide 14can be detachably mounted to the main body 12 is to provide a cuttingguide-receiving structure 20 associated with the main body 12, as shownin FIGS. 1-3. For example, as shown in FIG. 1, the cuttingguide-receiving structure 20 may be an opening or nesting structure andthe cutting guide 14 may be in the form of an insert sized to fit withinthe opening or nesting structure.

[0036] Referring now to FIG. 7A and 7C, in another aspect of theinvention, the bone graft forming guide includes a hole guide 36containing a plurality of hole guides 38 arranged in a pattern generallycorresponding to the desired shape of the bone graft. According to thisaspect of the invention, the hole guide 36 and the cutting guide 14 maybe selected as a pair having a similarly shaped pattern for forming abone graft. For example, hole guide insert 36 a shown in FIG. 7A woulddesirably be used with the cutting guide insert 36 b shown in FIG. 7B asdescribed further below to provide a bone graft having a wedge shape.Similarly, the hole guide insert 36 d shown in FIG. 7D would be usedwith the cutting guide insert 14 c shown in FIG. 7C to provide anelliptically shaped bone graft, as will be described further below. Itwill be understood, of course, that in accordance with the presentinvention, a wide variety of patterns can be provided in the hole guideand cutting guide to provide various shaped bone graft. The presentinvention desirably provides the advantage of enabling the surgeon tocustom select the size and shape of a bone graft in the operating roomto fit the graft to a particular patient and/or procedure.

[0037] Thus, according to the present invention, a bone graft formingguide is provided that includes at least a main body having a holder forholding a bone graft material and a cutting guide containing a patterncorresponding to the desired shape of the bone graft. According to thisaspect, the cutting guide is detachably mounted to the main body of theforming guide. In an alternative embodiment described above, the formingguide may optionally include a complementary hole guide for use with thecutting guide, the hole guide insert also adapted to be detachablymounted to the main body of the forming guide.

[0038] Referring now to FIG. 6, use of a hole guide is desirable toprovide a bone graft 38 having a roughened or irregular surface 40 on atleast a portion of the bone graft 38. As is known in the art, it isdesirable to provide a roughened surface on a portion of a bone graft toprevent the bone graft from backing out after insertion and promotefusion of the insert to adjacent tissue. For example, in a spinal fusionprocedure, a ruptured disc may be replaced with a bone graft, and theportions of the bone graft contacting the adjacent vertebrae maydesirably be roughened to promote fusion of the insert to the adjacentvertebrae. The present invention provides a simple and inexpensivemethod of forming a bone graft having a roughened surface.

[0039] According to another aspect of the invention (as shown in FIG.3), the bone graft forming guide includes a securing mechanism 42 forremovably securing one or both of the hole guide insert or the cuttingguide insert in the cutting guide-receiving structure 20, which may bein the form of an opening or nesting structure adapted to receive theinserts. Preferably, the securing mechanism 42 includes a cam memberassociated with the main body 12 of the forming guide. The cam member 42cooperates with one or both of the hole guide insert or the cuttingguide insert to secure the inserts to the main body 12. As shown in FIG.1, the insert may optionally include a ridge 44 adapted to cooperatewith the cam member to detachably secure the insert to the main body.

[0040] The forming guide preferably further includes a closure meanssuch as a clamping mechanism 46 for moving the two members 22 and 24towards each other to secure a bone graft material within the formingguide. As best shown in FIG. 1 and FIG. 4, the clamping mechanism 46 mayinclude a threaded rod 47 and nut 49 assembly. A bottom portion of thethreaded rod 47 may be secured to one of the members 22 in a manner toallow the threaded rod to pivot about the member 22 to move the threadedrod into and out of engagement with the other member 24. After thethreaded rod is moved into engagement with the other member 24, the nutassembly 49 may be rotated until the bone graft material 18 is securelyheld in the holder 16 of the main body 12 (as shown in FIG. 2 and FIG.5).

[0041] Of course, it will be understood that other closure means arewithin the scope of the invention. For example, the closure means caninclude a latch and hook assembly that is adapted to bias the twomembers 22 and 24 of the main body 12 together and hold bone graftmaterial 18 in the forming guide. Alternatively, the closure means couldinclude strap members that could be tightened to bias the two members 22and 24 together. In addition, the closure means could be provided byscrewing or bolting the main body members together, or any othersuitable closure means could be used to bias the main body memberstogether to hold the bone graft material in place during forming of thebone graft.

[0042] In use, the bone graft forming guide is preferably usedintraoperatively in an operating room where a bone graft insertionprocedure is performed. A surgeon would have on hand a bone graftmaterial, for example, a donor tibia bone as shown in the Figures, orthe surgeon would cut a portion of bone from the patient or obtain asynthetically formed bone graft material. The surgeon would determinethe size and shape of the bone graft that was needed for the particularprocedure and the patient and then cut the bone graft as follows.

[0043] According to one embodiment, the surgeon would place the bonegraft material 18 in the holder 16 of the forming guide 10 and selectfrom a plurality of cutting guides provided to the surgeon in advance.The surgeon would select the cutting guide insert that would provide theproperly sized and shaped bone graft for the patient and the particularprocedure. The surgeon or assistant would then associate the cuttingguide with the graft material holder, preferably by inserting a cuttingguide insert in the opening sized to receive the cutting guide insert.The cutting guide insert would then be secured to the main body of theforming guide by the cam member or other appropriate securing mechanism.The clamping mechanism would then be engaged to bring the two members 22and 24 of the main body 12 together and hold the bone graft material 18in place during cutting of the bone graft. The bone graft material wouldthen be at least partially cut along the pattern contained in thecutting guide to provide a bone graft having a desired shape. Cuttingcan be performed using any appropriate cutting device known in the art,such as a sagittal saw.

[0044] If it is desirable to provide a roughened or irregular surface onat least a portion of the bone graft, the step of cutting the bone graftis preferably preceded, but may be followed, by forming a plurality ofholes in a graft material, the plurality of holes forming a patterngenerally corresponding to the shape of the bone graft. In theembodiments shown in FIGS. 1-7, this can easily be achieved by firstinserting a hole guide insert in the insert-receiving opening in themain body, securing the insert with the securing mechanism, and thenforming a plurality of holes in the bone graft material by using atleast a portion of a plurality of the holes in the drill guide. As usedin this disclosure, the term “drill” and “drilling” is not intended tobe used in a limited manner to mean only traditional drill devices knownin the art. Forming the plurality of holes may be accomplished by usinga traditional drilling device and drill bits, or by other suitablemachining methods such as by laser or ultrasonics.

[0045] In one embodiment, after a plurality of holes have been formed inthe graft material, the hole guide insert may be removed from theopening in the main body, and a cutting guide insert may be placed inthe opening. The cutting guide is then secured to the main body, and thecutting operation is performed as described above. As one example, theresulting bone graft may appear as shown in FIG. 6, having a roughenedsurface 40. As mentioned above, the present invention provides theflexibility of providing a wide variety of bone graft shapes, including,but not limited to, grafts that are straight, wedge-shaped, andelliptically shaped.

[0046] According to additional embodiments of the invention shown inFIGS. 8 and 9, the bone graft forming guide 60 has a handle 64 having aproximal end 74 and a distal end 76. According to this embodiment, apair of jaws 78 and 80 extends from the distal end 76 of the handle 72.The jaws are movable between a gripping position to grip graft materialduring cutting of the bone graft and a releasing position to release thegraft material (not shown). Preferably, the handle 74 includes a pair ofarms connected to the pair of jaws 78 and 80 to provide the pair ofgripping members, and the gripping members are pivotally joined by pivotpoint 82. Preferably, the pair of arms includes a locking mechanism 84to lock the forming guide 60 in a plurality of positions. Thesepositions could include, for example, a closed position when the jawsare locked around the bone graft material during the cutting operation.

[0047] In a preferred aspect according to this embodiment, the holeguide and/or cutting guide are attached to at least one of the jaws thatmake up the pair of jaws. As shown in FIG. 8, the hole guide may beintegrally formed as part of the jaw. Alternatively, the hole guideand/or the cutting guide may be detachably mounted to at least one ofthe jaws as shown in FIG. 9a. As shown in FIG. 9A, attachment of theguides may be accomplished by screwing the guide to jaws, or by otherappropriate means.

[0048] The guide may also be associated with the jaws by providing aninsert receiving structure in the jaw and a hole guide insert and/or acutting guide insert which fits into the insert similar to the insertreceiving structure shown in FIGS. 1-7. Of course, if an insertstructure is used, a securing mechanism may be included to secure theinsert in to the jaw. Such securing mechanisms can include a cammechanism, a ball and spring detent structure, snap, clips, or any othermechanism for securing the inserts in the insert receiving structureduring cutting and forming of the bone graft.

[0049] As shown in FIGS., 9 b and 9 c, the inserts may be provided in avariety of shapes and sizes. FIG. 9b shows a cutting guide insert formaking a wedge-shape. FIG. 9c shows a combination hole-guide and cuttingguide insert having a pattern of hole guides and cutting guidesgenerally in the shape of an ellipse to form a elliptically-shaped bonegraft.

[0050] In use, the embodiments shown in FIGS. 8 and 9 can be usedintraoperatively in an operating room setting. Desirably, the surgeoncan be provided with several forming guides having a variety of sizedand shaped hole and cutting guides. The surgeon would determine theproper size and shape of the bone graft needed for the procedure. A bonegraft material, such as a donor bone, would be gripped between the jawsof the forming guide, and the surgeon or assistant would apply pressureto the handles so that the jaws close on the bone graft material. Thesecuring mechanism would lock the jaws in place, and the bone graftmaterial could be cut to the desired shape using an appropriate cuttingdevice such as a sagittal saw.

[0051] If it is desired to provide a bone graft implant having aroughened surface, forming holes in the graft material using at least aportion of the holes in a hole guide would precede the step of cuttingthe bone graft material. If the forming guide includes a combinationhole guide/cutting guide in the jaw as shown in FIG. 9c, the bone couldbe drilled and cut using the same forming guide without having torelease the bone graft material from the forming guide between thedrilling and cutting steps. However, if the forming guide does notinclude a combination drill guide/cutting guide separate forming guides(one including a drill guide, the other including a cutting) would beutilized. Alternatively, a forming guide having detachable inserts couldbe used and the drill guides would be detached from the jaws after thedrilling step and the cutting guides would be attached to the jaws priorto the cutting step.

[0052] The material for making the forming guide according to thepresent invention can be any material having the proper rigidity andstrength for holding the bone graft material during the cutting andforming operations. Accordingly, plastic, metals, ceramics, compositematerials, and combinations thereof can be utilized to form the variousparts of the forming guide. If it is desired to reuse the forming guide,the materials used to construct the forming guide should be designed towithstand sterilization procedures.

[0053] It will be apparent to those skilled in the art that variousmodifications and variations can be made in the forming guide and themethod of the present invention without departing from the spirit orscope of the invention. Thus, it is intended that the present inventioncover the modifications and variations of this invention provided theycome within the scope of the appended claims and their equivalents.

What is claimed is:
 1. A bone graft forming guide for providing a bonegraft having a desired shape comprising: a main body including a holderfor holding a graft material; a hole guide containing a plurality ofhole guides arranged in a pattern generally corresponding to the desiredshape of the bone graft; and a cutting guide containing a patterncorresponding to the desired shape of the bone graft.
 2. The bone graftforming guide of claim 1, wherein the hole guide is an insert and themain body includes a guide receiving opening for the insert.
 3. The bonegraft forming guide of claim 2, wherein the cutting guide is an insertand the main body includes a guide receiving opening for the insert. 4.The bone graft forming guide of claim 2, wherein the main body includesa block adapted to receive a graft material.
 5. A bone graft formingguide for providing a bone graft having a desired shape comprising: amain body including a holder for holding a bone graft material, the mainbody including a first portion and a second portion, at least one end ofthe two portions being joined together to provide a holder for holding agraft material during cutting, the main body having a receivingstructure adapted to receive an insert; a hole guide insert associatedwith the main body, the hole guide insert containing a plurality ofholes, the plurality of holes forming a pattern generally correspondingto the desired shape of the bone graft insert; and a cutting guideinsert associated with the main body, the cutting guide insertcontaining a pattern corresponding to the desired shape of the bonegraft.
 6. The bone graft forming guide of claim 5, wherein the holeguide insert and the cutting guide insert are removably insertablewithin the receiving structure.
 7. The bone graft forming guide of claim6, further including closure means for closing the two portions of themain body together to hold a bone graft material during forming of thebone graft.
 8. A bone graft forming guide for providing a bone grafthaving a desired shape comprising: a main body including a holder forholding a graft material and a cutting guide-receiving structure; and acutting guide containing a pattern corresponding to the desired shape ofthe bone graft, the cutting guide adapted to be detachably mounted tothe main body.
 9. The bone graft forming guide of claim 8, wherein thecutting guide-receiving structure and the cutting guide are adapted tocooperate with each other such that the cutting guide can be detachablymounted to the main body.
 10. The bone graft forming guide of claim 9,wherein the main body comprises a block adapted to receive a graftmaterial.
 11. An instrument for use in forming a bone graft from bonegraft material, said instrument comprising: a body capable of holdingsaid bone graft material; and a cutting guide associated with said body,wherein said cutting guide contains a pattern corresponding to a desiredshape of said bone graft, and wherein said pattern facilitates formingsaid bone graft having said desired shape.
 12. The instrument of claim11, wherein said body comprises a block having two hinged portionscapable of holding said bone graft material between said two hingedportions.
 13. The instrument of claim 12, wherein said body furthercomprises a clamping mechanism capable of urging said two hingedportions toward each other.
 14. The instrument of claim 12, wherein saidcutting guide is detachably mounted to said body.
 15. The instrument ofclaim 14, wherein said pattern of said cutting guide comprises aplurality of bores.
 16. The instrument of claim 15, wherein saidplurality of bores are interconnected.
 17. The instrument of claim 14,wherein said pattern of said cutting guide comprises at least one slot.18. The instrument of claim 14, wherein said body further comprises amounting structure to facilitate detachably mounting said cutting guideto said body.
 19. The instrument of claim 18, wherein said body furthercomprises a securing element to secure said cutting guide to saidmounting structure.
 20. The instrument of claim 12, wherein said twohinged portions each have bone graft material contacting surfaces, andwherein at least one of said bone graft material contacting surfaces isdeformable to facilitate holding said bone graft material when said bonegraft material is clamped between said two hinged portions of said bodyof said instrument.
 21. The instrument of claim 20, wherein said atleast one of said bone graft material contacting surfaces hasprotrusions.
 22. The instrument of claim 20, wherein said at least oneof said bone graft material contacting surfaces is non-linearlyconfigured to accommodate a cross-sectional shape of said bone graftmaterial.
 23. The instrument of claim 12, wherein said two hingedportions each have bone graft material contacting surfaces, and whereinat least one of said bone graft material contacting surfaces isnon-linearly configured to accommodate a cross-sectional shape of saidbone graft material.
 24. The instrument of claim 11, wherein saidpattern of said cutting guide comprises a plurality of bores.
 25. Theinstrument of claim 24, wherein said plurality of bores areinterconnected.
 26. The instrument of claim 11, wherein said pattern ofsaid cutting guide comprises at least one slot.
 27. An instrument foruse in forming a bone graft from bone graft material, said instrumentcomprising: a body capable of holding said bone graft material; apattern guide associated with said body, wherein said pattern guidefacilitates forming a pattern in said bone graft material correspondingto a desired shape of said bone graft; and a cutting guide associatedwith said body, wherein said cutting guide facilitates cutting throughsaid pattern in said bone graft material to form said desired shape ofsaid bone graft.
 28. The instrument of claim 27, wherein said bodycomprises a block having two hinged portions capable of holding saidbone graft material between said two hinged portions.
 29. The instrumentof claim 28, wherein said body further comprises a clamping mechanismcapable of urging said two hinged portions toward each other.
 30. Theinstrument of claim 28, wherein at least one of said pattern guide andsaid cutting guide is detachably mounted to said body.
 31. Theinstrument of claim 30, wherein said body further comprises a mountingstructure to facilitate detachably mounting said at least one of saidpattern guide and said cutting guide.
 32. The instrument of claim 31,wherein said body further comprises a securing element to secure said atleast one of said pattern guide and said cutting guide to said mountingstructure.
 33. The instrument of claim 28, wherein said two hingedportions each have bone graft material contacting surfaces, and whereinat least one of said bone graft material contacting surfaces isdeformable to facilitate holding said bone graft material when said bonegraft material is clamped between said two hinged portions of said bodyof said instrument.
 34. The instrument of claim 33, wherein said atleast one of said bone graft material contacting surfaces hasprotrusions.
 35. The instrument of claim 33, wherein said at least oneof said bone graft material contacting surfaces is non-linearlyconfigured to accommodate a cross-sectional shape of said bone graftmaterial.
 36. The instrument of claim 28, wherein said two hingedportions each have bone graft material contacting surfaces, and whereinat least one of said bone graft material contacting surfaces issubstantially conformingly configured to accommodate a cross-sectionalshape of said bone graft material.
 37. The instrument of claim 27,wherein said pattern guide comprises a plurality of bores which form atleast one outline.
 38. The instrument of claim 37, wherein said at leastone outline is arcuate.
 39. The instrument of claim 37, wherein said atleast one outline is linear.
 40. The instrument of claim 37, whereinsaid cutting guide contains at least one slot, said at least one slotbeing shaped substantially similar to said at least one outline on saidpattern guide, and said at least one slot being oriented on said cuttingguide substantially similar to an orientation of said at least oneoutline on said pattern guide.
 41. An instrument for use in forming abone graft from bone graft material, said instrument comprising: meansfor holding said bone graft material; and means for cutting through saidbone graft material in a pattern corresponding to a desired shape ofsaid bone graft to form said bone graft having said desired shape. 42.An instrument for use in forming a bone graft from bone graft material,said instrument comprising: means for holding said bone graft material;means for forming a pattern of bores in said bone graft material, saidpattern of bores corresponding to a desired shape of said bone graft;and means for cutting through said pattern of bores to form said desiredshape of said bone graft.